Does Medicare Cover Antidepressants?

Last Updated : 09/10/20183 min read

Your doctor might prescribe an antidepressant medication for you if you show certain symptoms, like loss of interest in your favorite activities. That’s according to the National Library of Medicine, which reports that depression affects about 19 million Americans.

Antidepressant medications are generally covered under Medicare Part D, which is optional prescription drug coverage.

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What is an antidepressant?

An antidepressant is simply a prescription medication used to treat depression, according to the National Institutes of Health. They work by changing a chemical balance in the brain. Antidepressants might take weeks to become effective, adds the NIH.

Does Medicare cover antidepressants?

In most cases, Original Medicare (Part A and Part B) don’t cover prescription drugs that you’d normally take at home. Part A generally covers medications you receive as part of your treatment as a hospital inpatient. Part B may cover certain medications administered to you as an outpatient – usually prescription drugs you wouldn’t take yourself, such as infusions.

For Medicare prescription drug coverage for antidepressants, you can sign up for a Medicare Prescription Drug Plan. There are two main types:

  • A stand-alone Medicare Part D Prescription Drug Plan that works alongside your Part A and/or Part B coverage
  • A Medicare Advantage Prescription Drug plan. This kind of plan delivers your Medicare Part A, Part B, and Part D benefits through a private, Medicare-approved insurance company. Hospice benefits, however, are still covered directly through Part A.

Both types of plan are available from private insurance companies approved by Medicare. And with either type, you still need to continue paying your monthly Part B premium, along with any premium your plan may charge.

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How do I know if a Medicare Prescription Drug Plan will cover my antidepressants?

Every Medicare Prescription Drug Plan has its own formulary, which is a list of covered medications. Each formulary can be different, and plans can choose to cover different medications. But there are certain prescription drugs that Medicare Prescription Drug Plans must cover – including antidepressants.

Not every plan will necessarily cover the same list of antidepressant medications, but each plan must cover most prescription drugs within the antidepressant class of medications.

A plan’s formulary may change at any time. You will receive notice from your plan when necessary.

If you’d like to explore Medicare plan options that may cover antidepressants, I’d be happy to help you.

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